Objectives: Our aim was to assess the clinical profiles and determine the precipitating factors for diabetic ketoacidosis (DKA) in adult patients admitted to a tertiary care center in United Arab Emirates (UAE). Materials and Methods: We conducted a retrospective analysis of all patients admitted with DKA at a tertiary care hospital in UAE during June 2014–December 2017. Variables recorded included gender, type of diabetes, and HbA1c on presentation and identified precipitating factors. Results: Data from a total of 255 patients with DKA were analyzed. One hundred and fifty-seven of these patients had type 1 diabetes (61.6%) whereas 69 patients were diagnosed with type 2 diabetes mellitus (T2DM) (27.1%), and 22 patients could not be classified as type 1 or type 2. A small number of patients (2.7%) were found to have secondary diabetes as their DKA was precipitated by acute pancreatitis. Around 12% of cases occurred in the setting of newly diagnosed diabetes. The most common precipitating factor for DKA was noncompliance to treatment (31.4%), followed by infections (22.7%). Pancreatitis was another important precipitating factor which accounted for 6.3% of the cases. Conclusions: DKA is not limited to patients with T1DM, and there seems to be a steady increase in its occurrence in patients with T2DM. Noncompliance to therapy is a major precipitating factor which needs to be addressed by offering better education programs to prevent hospitalization of these cases.

Clinical study on the application of acupoint injection therapy with vitamin B1 in patients with diabetic peripheral neuropathy

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Ran-Hui Kang, O Kwang-ChunDOI:10.4103/jdep.jdep_9_18

Context: Acupoint injection therapy with Vitamin B1is very effective in the management of diabetic peripheral neuropathy (DPN), and there are few adverse side effects. Aims: The overall purposes of our study are to determine the specific methods of acupoint injection therapy with Vitamin B1for patients with DPN and to demonstrate the effectiveness of this therapy for DPN patients. Settings and Design: The enrolled patients were divided into two groups – the experimental group (75 patients) and the control group (51 patients). Subjects and Methods: We used four main acupoints in our study – EX-B3, ST36, GB39, and GB34. We compared the changes of DPN symptoms, days of pain loss, changes of tendon reflexes, and electromyographic (EMG) parameters between two groups after 15 days of treatment. Statistical Analysis Used:T-test was used to compare the characteristics between different treatments. Results: The best acupoint set for performing the acupoint injection therapy with 5% Vitamin B1, includes EX-B3, ST36, GB34, and GB39. The mean efficiency rate in terms of changes of DPN symptoms was 84.5% that is significantly lower compared with 61.9% of control group. Furthermore, the day of the pain loss of experimental group was significant lower than that of control group and the efficiency rates in terms of patellar reflex and Achilles tendon reflex were 90.0% and 89.1%, respectively (P < 0.05). In the experimental group, EMG parameters were improved significantly. Conclusions: Our study suggests that the acupoint injection therapy with Vitamin B1is preferable, easier, and cost-effective approach in terms of DPN treatment.

Aims: The aim of this study is to retrospectively assess the effect of ongoing diabetes self-management education (DSME) on glycemic control among patients who received diabetes care at the Dubai Diabetes Center in Dubai, United Arab Emirates. Materials and Methods: The electronic medical records of all patients who attended the Dubai Diabetes Center for an initial visit between January and December 2015 were reviewed. Results: Patients who attended frequent follow-up visits (≥4 visits) within 1 year were found to have significantly lower HbA1c levels at the end of the 12-month study period as compared to those who attended less frequent follow-up visits (< visits). The mean difference in HbA1c from the initial visit was significantly greater in the group that attended frequent follow-up visits as compared to those who did not. The logistic regression analysis revealed the frequency of follow-ups to be a significant predictor of glycemic control, whereby patients who attended more frequent follow-ups had better glycemic control. Conclusions: Our research revealed the significance of frequent diabetes patient education on glycemic control in the United Arab Emirates. Our results can aid in shedding light that frequent and continued DSME can have a positive impact on disease outcomes in patients with diabetes.

Triple-A syndrome, also known as Allgrove syndrome, is an uncommon disorder which is inherited as an autosomal recessive disorder. About 100 cases have been described in literature. The three AAA comprises adrenal insufficiency secondary to adrenocorticotropic hormone (ACTH) resistance, achalasia cardia, and alacramia. We are reporting a case of a 10-year-old boy diagnosed as triple-A syndrome with ACTHresistant adrenal insufficiency, achalasia cardia, and alacrimia. He has alacramia since birth, and at the age of 7 years, he was diagnosed to have achalasia cardia. He developed the symptoms of adrenal insufficiency at the age of 9 years. Allgrove syndrome might be underreported in literature as the diagnosis requires high index of suspicion. In our patient, there was a delay of 3 years after the initial diagnosis of achalasia cardia. The diagnosis of Allgrove syndrrome should be considered in every child presenting with alacremia or achalasia cardia.